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Sacral Insufficiency Fractures - radiation damage

7243
Posts: 223
Joined: Feb 2011

I'm about 2 years post treatment and had my follow-up CT scan, which showed some changes in my sacrum.  My physicians recommended an an MRI to rule out any spread of cancer to the bones ... which showed Sacral Insufficiency Fractures (no cancer!).  Has anyone else encountered this complication, which causes pain in the lower back, buttocks, and hips ... likely associated with radiation damage to the sacrum. 

Thanks for any info about how this condition was treated, if this is an issue you are dealing with post treatment.  Thanks!  Wishing you all well.

 

 

 

Lorikat's picture
Lorikat
Posts: 566
Joined: Jul 2011

NOT YET!

mp327's picture
mp327
Posts: 3114
Joined: Jan 2010

Sacral Insufficiency Fractures are not uncommon after pelvic radiation.  I know of someone who suffered these and actually had a procedure where they put a type of glue on the fx's.  Getting an MRI will hopefully rule out any bone cancer and will not expose you to any additional radiation, at the same time showing exactly what is going on in that area.  Have you had a bone density scan since completing treatment?  It would show whether or not you have osteopenia or osteoporosis. 

7243
Posts: 223
Joined: Feb 2011

Yes ... Had an MRI same day, so all good there.  It actually confirmed the sacral fractures.  I'll plan a DEXA scan to establish osteopenia or osteoporosis.   I'm going to see about an ortho referral.   I think your friend may have had a  "sacroplasty" where they inject a special  glue.   I need to find an MD who deals with this in relatively high volume.  Will try to go very conservative re; physical therapy and such prior to anything invasive.  

So, I'm very glad to be "disease-free" at 2 years post treatment, but a bummer to deal with this complication...however,  it's all a trade-off as a survivor, right ?

Thanks Martha!  Appreciate any suggestions in addition to my plan!

mp327's picture
mp327
Posts: 3114
Joined: Jan 2010

"Sacroplasty" is the procedure my forum friend had.  She is located in Canada, but I'm sure there are doctors in the U.S. who perform this procedure.  It would definitely be worth checking out if P.T. or other measures do not help.  I wish you all the best and hope you are always disease-free!

larathon
Posts: 2
Joined: May 2013

I'm almost 6 years out post pelvic radiation for anal cancer.

I developed left buttock pain during a run which was diagnosed nearly 2 months later as an insufficiency fracture of the sacrum by MRI.

I'm seeing an orthopedic doc with experience in sacral fractures tomorrow.

Any update on the treatment strategy for your fracture?

mp327's picture
mp327
Posts: 3114
Joined: Jan 2010

I am a runner too.  So far, so good for me and my bones, although I do have osteopenia.  I hope your appt. with the ortho goes well tomorrow.  Please let us know what your treatment plan will be.

larathon
Posts: 2
Joined: May 2013

Ortho doc ordered DEXA scan (next week) and repeat MRI in 6 weeks. No running until re-scan evaluation to assess healing. Suggested 3000-5000 IU Vitamin D/day and & 1200 mg Ca++.  Sacroplasty not mentioned. My symptoms have improved since onset March 2, so I guess I'm healing!

mp327's picture
mp327
Posts: 3114
Joined: Jan 2010

I'm glad to hear you have improved!  The supplements can be helpful, but the ideal way to get both Vitamin D and Calcium is through diet and exposure to sunlight.  I used to eat calcium pills like they were candy, but have reduced my dosage and now eat a diet heavy on calcium-rich foods.  However, it wasn't due entirely to choice.  I had an intestinal obstruction in late January and was put on a low-residue/soft diet, which cuts out a lot of foods.  However, yogurt, puddings, creamed soups, etc. were things I could eat.  One day I decided to total up how much calcium I had consumed that day and it was a lot, so that's when I decided to back down on the supplements.  I'm glad you are getting a DEXA scan.  I have had a couple since treatment ended and my second one actually was improved over the first one, but still shows osteopenia.  I hope you will get encouraging results and be able to resume running real soon! 

NYinTX's picture
NYinTX
Posts: 64
Joined: Feb 2013

can u share some of ur Calcium-rich recipes?? Thanks

mp327's picture
mp327
Posts: 3114
Joined: Jan 2010

I really don't cook from recipes.  I make puddings with milk, such as tapioca, eat a lot of yogurt and cottage cheese.

sandysp's picture
sandysp
Posts: 852
Joined: May 2011

My bone density report just came back showing osteoporosis in the spine between L3 and 4, I believe. Anyway, very low back. This was a big change for me. I had almost reversed osteopenia prior to cancer treatment. They told me to up my Vitamin D and take calcium supplements even if my diet is rich in calcium. I have a calcium rich diet via greens, soy products, sesame seeds and walnuts (I don't do dairy any more) since discovering there is no correlation between eating dairy and bone health anyway. In northern climates, it is a good idea to supplement Vitamin D. Gel caps are a pretty reliable delivery system, either that or taking it in liquid form. I take Green Vibrance every day and have decided to take it more than once a day to make sure I get the calcium and vitamin D I need. 5000 units daily is recomended now by most nutritionists. It is a terrific product. Magnesium is a key player too. Walnuts have lots of magnesium. I use them in all my salads and deserts now guilt free. Yummm!

All the best,

Sandy

NYinTX's picture
NYinTX
Posts: 64
Joined: Feb 2013

is this the stuff? how do you know it works for you? feel different?

 

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